Development and Validation of Global Leadership Initiative on Malnutrition for Prognostic Prediction in Patients Who Underwent Cardiac Surgery

The Global Leadership Initiative on Malnutrition (GLIM) has achieved a consensus for the diagnosis of malnutrition in recent years. This study aims to determine the prognostic effect of the GLIM after cardiac surgery. A total of 603 patients in the training cohort and 258 patients in the validation cohort were enrolled in this study. Perioperative characteristics and follow-up data were collected. A nomogram based on independent prognostic predictors was developed for survival prediction. In total, 114 (18.9%) and 48 (18.6%) patients were defined as being malnourished according to the GLIM criteria in the two cohorts, respectively. Multivariate regression analysis showed that GLIM-defined malnutrition was an independent risk factor of total complication (OR 1.661, 95% CI: 1.063–2.594) and overall survival (HR 2.339, 95% CI: 1.504–3.637). The c-index was 0.72 (95% CI: 0.66–0.79) and AUC were 0.800, 0.798, and 0.780 for 1-, 2-, and 3-year survival prediction, respectively. The calibration curves of the nomogram fit well. In conclusion, GLIM criteria can efficiently identify malnutrition and has a prognostic effect on clinical outcomes after cardiac surgery. GLIM-based nomogram has favorable performance in survival prediction.     

Safety and efficacy of anti-EGFR monoclonal antibody (SCT200) as second-line therapy in advanced esophageal squamous cell carcinoma

Objective: The mainstay treatment of esophageal squamous cell carcinoma(ESCC) involves chemotherapy and immunotherapy. However, alternative therapies are required for patients who are refractory or intolerant to existing therapies.Methods: In this single-arm, multicenter, open-label phase Ib study, 30 patients received an intravenous infusion of SCT200, an antiepidermal growth factor receptor(EGFR) monoclonal antibody, 6.0 mg/kg once a week for 6 weeks, followed by 8.0 mg/kg once every 2 weeks u...     

CD137-CD137配体对巨噬细胞基质金属蛋白酶9及血管平滑肌细胞钙化形成的影响

目的探讨CD137-CD137配体(CD137L)信号是否通过调控巨噬细胞基质金属蛋白酶9(MMP-9)的表达影响血管平滑肌细胞(VSMC)钙化形成。方法采用巯基乙酸盐腹腔灌洗法获取C57BL/6J小鼠腹腔巨噬细胞(PM),采用组织块贴壁法取3~6代胸主动脉VSMC分为对照组、共培养组、CD137激动组和MMP-9抑制组(n=3)。对照组用重组CD137L蛋白干预VSMC,共培养组用PM和VSMC共培养,CD137激动组和MMP-9抑制组分别用重组CD137L蛋白和MMP-9抑制剂干预PM后,与VSMC共培养,再加入重组CD137蛋白(10μg/ml)干预。采用Western blot检测各组钙化相关的骨桥蛋白(OPN)、Runt相关转录因子2(Runx-2)表达,微板法检测钙离子浓度和碱性磷酸酶(ALP)活性,Von Kossa和茜素红染色检测各组细胞钙化程度。结果CD137激动组VSMC中OPN和Runx-2蛋白表达、钙离子浓度及ALP活性明显高于共培养组(P<0.01),而MMP-9抑制组VSMC中OPN和Runx-2蛋白表达、钙离子浓度及ALP活性明显低于CD137激动组,差异有统计学意义[0.25±0.27 vs 2.12±0.34,0.30±0.32 vs 2.63±0.41,(1.92±0.09)mmol/g vs(4.99±0.37)mmol/g,(1.11±0.50)KU/g vs(2.63±0.04)KU/g,P<0.01]。共培养组VSMC中OPN和Runx-2蛋白表达、钙离子浓度及ALP活性与对照组比较,无统计学意义(P>0.05)。CD137激动组茜素红染色红色颗粒物质沉积和Von Kossa染色黑色颗粒物质沉积明显多于对照组和共培养组;MMP-9抑制组钙化程度显著降低;对照组和共培养组钙化程度则无明显差异。结论CD137-CD137L信号可能通过调控巨噬细胞MMP-9表达影响VSMC钙化形成。     

Hydroxysafflor Yellow A Attenuates Bleomycin‐induced Pulmonary Fibrosis in Mice

Hydroxysafflor yellow A (HSYA) is an active component of Carthamus tinctorius L., and we want to investigate whether HSYA attenuates pulmonary fibrosis induced by bleomycin (BLM) in mice. The mice received a BLM via oropharyngeal aspiration, and HSYA was intraperitoneally injected. Arterial blood gas analysis was performed. Morphological changes and hydroxyproline content were measured. mRNA expression of transforming growth factor‐β1 (TGF‐β1), connective tissue growth factor, α‐smooth muscle actin (α‐SMA), and collagen I was measured by real‐time polymerase chain reaction. α‐SMA‐positive cells in lung tissues were detected by immunohistochemical staining. A549 cell was cultured, and morphological changes were observed after TGF‐β1 and HSYA treatment. mRNA expression was detected by real‐time polymerase chain reaction. Phosphorylation of Smad3 was evaluated by western blotting. HSYA decreased the lung consolidation area and collagen deposition in mice with pulmonary fibrosis. The blood gas changes due to BLM were attenuated by HSYA. HSYA also alleviated the BLM‐induced increase of TGF‐β1, connective tissue growth factor, α‐SMA, and collagen I mRNA levels. HSYA treatment inhibited the increase of α‐SMA expression, Smad3 phosphorylation, the morphological changes in lung tissue. HSYA inhibits Smad3 phosphorylation and elevated expression of collagen I mRNA in epithelial–mesenchymal transition induced by TGF‐β1. Copyright © 2016 John Wiley & Sons, Ltd.     

中西医结合治疗慢性再生障碍性贫血30例

慢性再生障碍性贫血（Chronic Aplastic Anemia,CAA）是一组由多种病因引起的骨髓造血功能衰竭,以造血干细胞损伤、外周血全血细胞减少为特征的难治性血液病,临床上常表现为贫血、出血和感染。治疗主要予雄性激素、免疫抑制剂治疗,其疗效已被临床证实,但复发问题严重,长期应用不良反应多。2005年12月-2010年7月,我们采用自拟补肾益髓汤伍用雄激素司坦唑醇治疗,取得了满意的疗效,现报道如下。     

脊髓损伤后神经营养因子及干细胞治疗对轴突再生的影响：国外基础和临床研究新进展

背景:近几年国外学者在脊髓损伤的病理机制、损伤后神经元的保护、少突胶质细胞的再生及神经干细胞的移植治疗等研究方面取得了实质性地进展。介绍国外近10年来对脊髓损伤的新认识,最新研究成果及未来的科研和治疗方向。资料来源:应6用计算机检索Medline数据库1987-01/2006-10脊髓损伤的相关文章,限定文章语言种类为English,检索词为“脊髓损伤;神经干细胞;轴突;神经营养因子;动物模型”,进行不同组合,选出相关文章。资料选择:对资料进行初审,选择脊髓研究中的与神经干细胞及神经营养因子有关的研究文献查找全文。纳入标准:①脊髓损伤中以探讨其机制及新治疗方法的文章。②探讨脊髓损伤后轴突再生,生长锥作用,引导再生方向的靶点,突触再形成及功能重建的文章。③神经营养因子和内源性神经干细胞治疗的文章。排除标准:①未被SCI收录的文章,相类似的研究。②无英文摘要的文章。资料提炼:共收集到相关文献1166篇,按上述标准纳入101篇,实际采用61篇,脊髓损伤机制相关文献12篇,轴突再生相关文献14篇,增长锥作用相关文献8篇,少突胶质细胞相关文献8篇,神经干细胞相关文献7篇,神经生长因子相关文献12篇。其余文献均被排除。资料综合:①脊髓损伤功能恢复的基础:损伤的轴突再生及增长;轴突穿透损伤瘢痕区的能力;轴突朝着正确的靶区方向再生;轴突增长到一定程度后停止,终端形成突触,与神经元相接;神经传递功能重建及运动功能重新恢复。②脊髓损伤的神经病理分析:脊髓损伤后的原发性损害、继发性损害。③脊髓损伤的分子生物学机制包括3个方面:对于成年人中枢神经系统损伤后的神经元的发展、再生,神经元通路的建立起着重要的作用轴突增长锥;对轴突的再生起到抑制作用中枢神经系统髓鞘蛋白;细胞膜和细胞内信号传递。④脊髓损伤中起重要作用的细胞和因子:少突胶质细胞,白血病抑制因子和Minocycline,内源性神经干细胞。⑤脊髓损伤动物模型:最常使用的模型是全部离断、部分离断模型和挫伤模型。⑥脊髓损伤研究的前景:已经开始把动物实验中神经营养因子和神经干细胞治疗发现用于临床,如白血病抑制因子在国外已经开始临床Ⅳ期实验,对内源性神经干细胞的诱导调控增殖研究也已经越来越受到重视。结论:神经营养因子干预治疗及神经干细胞治疗使脊髓损伤后的功能恢复成为可能。进一步探讨神经营养因子引起轴突再生的机制,将是脊髓损伤研究领域的未来方向,了解引导调控神经干细胞的增殖和分化方向,将在修复脊髓损伤方面发挥巨大的作用。     

《内科护理学》PBL教学案例评价问卷的研究与分析

[目的]编制适合学生使用的《内科护理学》以问题为基础的教学法（PBL）教学案例评价问卷并考评其信度和效度.[方法]以教学评价理论中涉及的7大结构系统以及教学案例评估标准为理论框架,结合案例教学及高职护生的实际情况,编制《内科护理学》PBL教学案例评价问卷.采用专家咨询法进行内容效度检测,并对213名高职护生进行问卷调查,进行信度、结构效度检验.[结果]问卷包括案例使用的教学效果评价（10个条目）、案例设计评价（10个条目）、教师应用案例的授课情况评价（7个条目）3个维度,共27个条目.问卷总的Cronbach＇s α系数为0.852,问卷分半信度为0.756,各维度Cronbach＇s α系数分别为0.815,0.763,0.722.问卷总的内容效度为0.950,各维度内容效度分别为0.970,0.960,0.920,各维度间相关系数为0.396～0.610.3个因子解释总的变异为77.021％,条目因子载荷为0.449～0.790.[结论]《内科护理学》PBL教学案例评价问卷具有较好的信度和效度,最终问卷与理论构想总体基本吻合,其所含条目具有良好的独立性和敏感性.     

MicroRNA-137 inhibits cell migration and invasion by targeting bone morphogenetic protein-7 (BMP7) in non-small cell lung cancer cells

MicroRNA-137 (miR-137) was reported to be dysregulated in several human cancers. However, the function and mechanism of miR-137 in non-small cell lung cancer (NSCLC) is still unclear. In the current study, we explored the role of miR-137 in NSCLC progression. Using qRT-PCR, our data showed that miR-137 was significantly down-regulated in NSCLC tissues and cell lines. In vitro functional assay, we found that over-expression of miR-137 suppressed NSCLC cells proliferation, migration and invasion, indicating that miR-137 could act as a tumor suppressor in NSCLC progression. In addition, bone morphogenetic protein-7 (BMP7) was identified as a target of miR-137 in NSCLC cells, Luciferase reporter assay suggested that miR-137 directly targeted 3’-UTR of BMP7, and correlation analysis revealed that BMP7 inversely correlated with miR-137 in NSCLC tissues. Furthermore, Restoration of BMP7 remarkably reversed the tumor suppressive effects of miR-137 on NSCLC cell proliferation, migration, and invasion. Taken together, our findings suggested that miR-137/BMP7 axis could contribute to the progression of NSCLC, suggesting miR-137 as a potential therapeutic target for the treatment of NSCLC.